Epidemiology, prevention and control of oral diseases in pediatric subjects

Caries and periodontal diseases are a neglected epidemic by millions of Italians who suffer unnecessarily from them. Both diseases are preventable and the combination of high prevalence, high morbidity and relative inattention from the National Health Service (NHS), makes caries and periodontal disease a significant public health problem. In this perspective, the World Health Organization and the University of Milan have promoted a national epidemiological study aimed at a sample of 4, 6 and 12-years-old students from schools in the North, Central and South of Italy. The study provides for the administration of a questionnaire to parents and a dental examination carried out at school by dentists trained by the WHO. In our town the epidemiological study planning and the survey were carried out by professors of the School of Specialization in "Pediatric Dentistry" (Prof. G. Giuliana and Prof. G. Pizzo) supported by specialist dentists from the same School, calibrated according to the WHO methodology. The survey was carried out between 2017 and 2019 involving 2701 children attending schools in the 8 districts of the town. The parents were sent a letter which explained the nature of the survey and contained a pre-printed form for the issue of informed consent to participate in the survey with a questionnaire regarding the family nuclear, the oral hygiene and eating habits of the minor and the child's previous dental experiences. The ICDAS (International Caries Detection and Assessment System) was used to detect the prevalence of carious lesions. The dentist used for each child visited a dental mirror and the CPI (Community Periodontal Index) index for periodontal assessment. Preliminary results showed that 25.3% of 12-years-old students had gingival bleeding and 41.1% had tartar. The caries index (ICDAS) shows us that as early as 4 years, 20% of children have initial carious lesions, 37% have dentine caries and that 34.38% have highly destructive caries. At 12 years, 34.95% had initial carious lesions, 46% had cavities that already affected dentin and that 42.44% had highly destructive cavities. The exigence to implement a program of prevention / early treatment of caries/gingivitis in pediatric subjects living in Palermo, since the first months of child's life, was born from the data analysis. The project "Un sorriso per 54 tutti i bambini", carried out at the U.O. of "Pediatric Dentistry" of Policlinico Paolo Giaccone in Palermo, was therefore finalised in order to 1) improve efficiency and effectiveness in the promotion of the oral health of minors, through the creation of a preventive / assistance route of significant social health impact; 2) assess the effectiveness of the preventive methodologies adopte

Window-Based Energy Selecting X-ray Imaging and Charge Sharing in Cadmium Zinc Telluride Linear Array Detectors for Contaminant Detection

The spectroscopic and imaging performance of energy-resolved photon counting detectors, based on new sub-millimetre boron oxide encapsulated vertical Bridgman cadmium zinc telluride linear arrays, are presented in this work. The activities are in the framework of the AVATAR X project, planning the development of X-ray scanners for contaminant detection in food industry. The detectors, characterized by high spatial (250 µm) and energy (<3 keV) resolution, allow spectral X-ray imaging with interesting image quality improvements. The effects of charge sharing and energy-resolved techniques on contrast-to-noise ratio (CNR) enhancements are investigated. The benefits of a new energy-resolved X-ray imaging approach, termed window-based energy selecting, in the detection of low- and high-density contaminants are also shown

Advances in High-Energy-Resolution CdZnTe Linear Array Pixel Detectors with Fast and Low Noise Readout Electronics

: Radiation detectors based on Cadmium Zinc Telluride (CZT) compounds are becoming popular solutions thanks to their high detection efficiency, room temperature operation, and to their reliability in compact detection systems for medical, astrophysical, or industrial applications. However, despite a huge effort to improve the technological process, CZT detectors' full potential has not been completely exploited when both high spatial and energy resolution are required by the application, especially at low energies (<10 keV), limiting their application in energy-resolved photon counting (ERPC) systems. This gap can also be attributed to the lack of dedicated front-end electronics which can bring out the best in terms of detector spectroscopic performances. In this work, we present the latest results achieved in terms of energy resolution using SIRIO, a fast low-noise charge sensitive amplifier, and a linear-array pixel detector, based on boron oxide encapsulated vertical Bridgman-grown B-VB CZT crystals. The detector features a 0.25-mm pitch, a 1-mm thickness and is operated at a -700-V bias voltage. An equivalent noise charge of 39.2 el. r.m.s. (corresponding to 412 eV FWHM) was measured on the test pulser at 32 ns peaking time, leading to a raw resolution of 1.3% (782 eV FWHM) on the 59 keV line at room temperature (+20 °C) using an uncollimated 241Am, largely improving the current state of the art for CZT-based detection systems at such short peaking times, and achieving an optimum resolution of 0.97% (576 eV FWHM) at 1 µs peaking time. The measured energy resolution at the 122 keV line and with 1 µs peaking time of a 57Co raw uncollimated spectrum is 0.96% (1.17 keV). These activities are in the framework of an Italian collaboration on the development of energy-resolved X-ray scanners for material recycling, medical applications, and non-destructive testing in the food industry

High performance platinum contacts on high-flux CdZnTe detectors

The need for direct X-ray detection under high photon flux with moderate or high energies (30–100 keV range) has strongly increased with the rise of the 4th Generation Synchrotron Light Sources, characterised by extremely brilliant beamlines, and of other applications such as spectral computed tomography in medicine and non-destructive tests for industry. The novel Cadmium Zinc Telluride (CZT) developed by Redlen Technologies can be considered the reference material for high-flux applications (HF-CZT). The enhanced charge transport properties of the holes allow the mitigation of the effects of radiation induced polarization phenomena, typically observed in standard CZT materials (LF-CZT) under high photon flux. However, standard LF-CZT electrical contacts led to inacceptable high dark leakage currents on HF-CZT devices. In this work, a detailed study on the characteristics of new optimized sputtered platinum electrical contacts on HF-CZT detectors is reported. The results from electrical and spectroscopic investigations, showed the best performances on HF-CZT detectors with platinum anode, coupled with both platinum or gold cathode. The morphology, structure, and composition of Pt/CZT contact have been analysed by means of Transmission Electron Microscopy (TEM) on microscopic lamellas obtained by Focused Ion Beam (FIB), highlighting the presence of CdTeO3 oxide at the metal semiconductor interface

Advances in High-Energy-Resolution CdZnTe Linear Array Pixel Detectors with Fast and Low Noise Readout Electronics

Radiation detectors based on Cadmium Zinc Telluride (CZT) compounds are becoming popular solutions thanks to their high detection efficiency, room temperature operation, and to their reliability in compact detection systems for medical, astrophysical, or industrial applications. However, despite a huge effort to improve the technological process, CZT detectors’ full potential has not been completely exploited when both high spatial and energy resolution are required by the application, especially at low energies (<10 keV), limiting their application in energy-resolved photon counting (ERPC) systems. This gap can also be attributed to the lack of dedicated front-end electronics which can bring out the best in terms of detector spectroscopic performances. In this work, we present the latest results achieved in terms of energy resolution using SIRIO, a fast low-noise charge sensitive amplifier, and a linear-array pixel detector, based on boron oxide encapsulated vertical Bridgman-grown B-VB CZT crystals. The detector features a 0.25-mm pitch, a 1-mm thickness and is operated at a −700-V bias voltage. An equivalent noise charge of 39.2 el. r.m.s. (corresponding to 412 eV FWHM) was measured on the test pulser at 32 ns peaking time, leading to a raw resolution of 1.3% (782 eV FWHM) on the 59 keV line at room temperature (+20 °C) using an uncollimated 241Am, largely improving the current state of the art for CZT-based detection systems at such short peaking times, and achieving an optimum resolution of 0.97% (576 eV FWHM) at 1 µs peaking time. The measured energy resolution at the 122 keV line and with 1 µs peaking time of a 57Co raw uncollimated spectrum is 0.96% (1.17 keV). These activities are in the framework of an Italian collaboration on the development of energy-resolved X-ray scanners for material recycling, medical applications, and non-destructive testing in the food industry

Automated Stabilization, Enhancement and Capillaries Segmentation in Videocapillaroscopy

Oral capillaroscopy is a critical and non-invasive technique used to evaluate microcirculation. Its ability to observe small vessels in vivo has generated significant interest in the field. Capillaroscopy serves as an essential tool for diagnosing and prognosing various pathologies, with anatomic–pathological lesions playing a crucial role in their progression. Despite its importance, the utilization of videocapillaroscopy in the oral cavity encounters limitations due to the acquisition setup, encompassing spatial and temporal resolutions of the video camera, objective magnification, and physical probe dimensions. Moreover, the operator’s influence during the acquisition process, particularly how the probe is maneuvered, further affects its effectiveness. This study aims to address these challenges and improve data reliability by developing a computerized support system for microcirculation analysis. The designed system performs stabilization, enhancement and automatic segmentation of capillaries in oral mucosal video sequences. The stabilization phase was performed by means of a method based on the coupling of seed points in a classification process. The enhancement process implemented was based on the temporal analysis of the capillaroscopic frames. Finally, an automatic segmentation phase of the capillaries was implemented with the additional objective of quantitatively assessing the signal improvement achieved through the developed techniques. Specifically, transfer learning of the renowned U-net deep network was implemented for this purpose. The proposed method underwent testing on a database with ground truth obtained from expert manual segmentation. The obtained results demonstrate an achieved Jaccard index of 90.1% and an accuracy of 96.2%, highlighting the effectiveness of the developed techniques in oral capillaroscopy. In conclusion, these promising outcomes encourage the utilization of this method to assist in the diagnosis and monitoring of conditions that impact microcirculation, such as rheumatologic or cardiovascular disorders

Potentialities of High-Resolution 3-D CZT Drift Strip Detectors for Prompt Gamma-Ray Measurements in BNCT

Recently, new high-resolution cadmium–zinc–telluride (CZT) drift strip detectors for room temperature gamma-ray spectroscopic imaging were developed by our group. The CZT detectors equipped with orthogonal anode/cathode collecting strips, drift strips and dedicated pulse processing allow a detection area of 6 × 20 mm2 and excellent room temperature spectroscopic performance (0.82% FWHM at 661.7 keV). In this work, we investigated the potentialities of these detectors for prompt gamma-ray spectroscopy (PGS) in boron neutron capture therapy (BNCT). The detectors, exploiting the measurement of the 478 keV prompt gamma rays emitted by 94%7Li nuclides from the10B(n, α)7Li reaction, are very appealing for the development of single-photon emission computed tomography (SPECT) systems and Compton cameras in BNCT. High-resolution gamma-ray spectra from10B samples under thermal neutrons were measured at the T.R.I.G.A. Mark II research nuclear reactor of the University of Pavia (Italy)

Incomplete Charge Collection at Inter-Pixel Gap in Low-and High-Flux Cadmium Zinc Telluride Pixel Detectors

The success of cadmium zinc telluride (CZT) detectors in room-temperature spectroscopic X-ray imaging is now widely accepted. The most common CZT detectors are characterized by enhanced-charge transport properties of electrons, with mobility-lifetime products µeτe > 10−2 cm2/V and µhτh > 10−5 cm2/V. These materials, typically termed low-flux LF-CZT, are successfully used for thick electron-sensing detectors and in low-flux conditions. Recently, new CZT materials with hole mobility-lifetime product enhancements (µhτh > 10−4 cm2/V and µeτe > 10−3 cm2/V) have been fabricated for high-flux measurements (high-flux HF-CZT detectors). In this work, we will present the performance and charge-sharing properties of sub-millimeter CZT pixel detectors based on LF-CZT and HF-CZT crystals. Experimental results from the measurement of energy spectra after charge-sharing addition (CSA) and from 2D X-ray mapping highlight the better charge-collection properties of HF-CZT detectors near the inter-pixel gaps. The successful mitigation of the effects of incomplete charge collection after CSA was also performed through original charge-sharing correction techniques. These activities exist in the framework of international collaboration on the development of energy-resolved X-ray scanners for medical applications and non-destructive testing in the food industry

Recent advances in the development of high-resolution 3D cadmium zinc telluride drift strip detectors

In the last two decades, great efforts have been made in the development of 3D cadmium-zinc-Telluride (CZT) detectors operating at room temperature for gamma-ray spectroscopic imaging. This work presents the spectroscopic performance of new high-resolution CZT drift strip detectors, recently developed at IMEM-CNR of Parma (Italy) in collaboration with due2lab (Italy). The detectors (19.4 mm × 19.4 mm × 6 mm) are organized into collecting anode strips (pitch of 1.6 mm) and drift strips (pitch of 0.4 mm) which are negatively biased to optimize electron charge collection. The cathode is divided into strips orthogonal to the anode strips with a pitch of 2 mm. Dedicated pulse processing analysis was performed on a wide range of collected and induced charge pulse shapes using custom 32-channel digital readout electronics. Excellent room-Temperature energy resolution (1.3% FWHM at 662 keV) was achieved using the detectors without any spectral corrections. Further improvements (0.8% FWHM at 662 keV) were also obtained through a novel correction technique based on the analysis of collected-induced charge pulses from anode and drift strips. These activities are in the framework of two Italian research projects on the development of spectroscopic gamma-ray imagers (10-1000 keV) for astrophysical and medical applications

Potentialities of CdZnTe Quasi-Hemispherical Detectors for Hard X-ray Spectroscopy of Kaonic Atoms at the DAΦNE Collider

Kaonic atom X-ray spectroscopy is a consolidated technique for investigations on the physics of strong kaon-nucleus/nucleon interaction. Several experiments have been conducted regarding the measurement of soft X-ray emission (<20 keV) from light kaonic atoms (hydrogen, deuterium, and helium). Currently, there have been new research activities within the framework of the SIDDHARTA-2 experiment and EXCALIBUR proposal focusing on performing precise and accurate measurements of hard X-rays (>20 keV) from intermediate kaonic atoms (carbon, aluminum, and sulfur). In this context, we investigated cadmium-zinc-telluride (CdZnTe or CZT) detectors, which have recently demonstrated high-resolution capabilities for hard X-ray and gamma-ray detection. A demonstrator prototype based on a new cadmium-zinc-telluride quasi-hemispherical detector and custom digital pulse processing electronics was developed. The detector covered a detection area of 1 cm2 with a single readout channel and interesting room-temperature performance with energy resolution of 4.4% (2.6 keV), 3% (3.7 keV), and 1.4% (9.3 keV) FWHM at 59.5, 122.1, and 662 keV, respectively. The results from X-ray measurements at the DAΦNE collider at the INFN National Laboratories of Frascati (Italy) are also presented with particular attention to the effects and rejection of electromagnetic and hadronic background